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Introduction.
Chronic obstructive pulmonary disease (COPD) is a global public health problem. The presence of comorbidity in patients with COPD and acute myocardial infarction (AMI) worsens the course and prognosis of these diseases.
Purpose. To identify risk factors (RF) for the development of AMI in patients with COPD, depending on the severity.
Methods.
90 patients with COPD were examined, who were divided into 2 groups: group 1 (n = 50) with COPD and AMI, of which 27 patients with moderate COPD and 23 patients with severe COPD, group 2 (n = 40) with COPD without AMI, including 21 patients with moderate COPD and 19 patients with severe COPD. All patients underwent a complete clinical and instrumental examination. Statistical processing of the obtained data was carried out using the Statistica 10.0.
Results.
At the first stage, the correlation analysis was used to determine the variables that, at a reliable level of p=0.05, indicate the presence of a relationship between the presence or absence of AMI and the selected FR. For patients with moderate and severe COPD, these variables are: age, left ventricular ejection fraction (LVEF), systolic pulmonary artery pressure (SPAP), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) levels, forced expiratory volume in 1 second (FEV1), Tiffno index (TI), flow-dependent vasodilation into the systole, right ventricular end-diastolic volume (RVEDV), right ventricular ejection fraction (RVEF).
At the second stage, a discriminant analysis was performed, which showed (F=30.884, p=0.00001) that the most significant dividing properties for the presence/absence of AMI in patients with moderate COPD are SPAP (Wilkes' lambda=0.26, p=0.0001), LDL (Wilkes' lambda=0.14, p=0.01), HDL (Wilkes' lambda=0.11, p=0.05), FEV1 (Wilkes' lambda=0,12, p=0,05), for patients with severe COPD at F=25,264 (p=0.0001) - smoking history (Wilkes' lambda=0.06, p=0.01), C-reactive protein level (Wilkes' lambda=0.5, p=0.01), SPAP (Wilkes' lambda=0.09, p=0.008), LDL level (Wilkes' lambda=0.06, p=0.03), the level of HDL (Wilkes' lambda=0.0009, p=0.0007), TI (Wilkes' lambda=0.05, p=0.001), RVEDV (Wilkes' lambda=0.06, p=0.03).
At the third stage, when using logistic regression among 48 patients with moderate COPD, the most significant independent variables for determining the risk of AMI were: LVEF, LDL level, FEV1, flow-dependent vasodilation, among 42 patients with severe COPD - smoking history, RVEDV, HDL, C-reactive protein level, TI.
Conclusion.
Thus, the use of these indicators to determine the individual risk of AMI in patients with moderate and severe COPD makes it possible to start a timely set of preventive measures aimed at preventing the development of acute coronary events in patients with COPD, thereby improving the prognosis of the disease and the quality of life of comorbid patients.

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